Sunday, September 23, 2012

Right at the top of the list of 10 most humiliating things for a man has to be having a female point and laugh at his genitalia.

No, it's not what you might think. I'm talking about my daughter- we do family showers- a necessity when you need extra hands to keep the monster under control. But being an innocent little toddler, she finds things that are, ahem, different, to be funny.

And so, she never seems to point and laugh at mommy's nakedness, but inevitably, points at my nether regions and just guffaws.

Wednesday, September 19, 2012

One Month!

How time flies.

It's been a month. We celebrated Ava's 'full moon' last weekend. Thanks to mom, we had a yummy feast even without the customary roast pork. We did have the red eggs though.

Mom leaves for Malaysia after a 6 week visit. We've been lucky to have her here to help, but what's more precious is that she was able to spend some time with her new grand daughter. It really warms the heart seeing your parent interact with your child.

After she leaves, I suspect Kris and I will be facing new challenges as 'new' parents to 2 with no extra help. Alas, no domestic help or 'confinement ladies' here. While daycare, especially when they both start going, will cost more than a car annually! Definitely one of those things I miss from Malaysia.

Thursday, September 13, 2012

Lies

To call someone a liar is a strong term. And as much as I can, I believe in showing people some respect as I feel we all deserve that much. But admittedly, I'm not keen on seeing a particular patient tomorrow (assuming he shows up).

I had been involved with L for the last 3 years. A young man with poorly controlled diabetes, someone I 'inherited' from the pediatric endocrinologist when he became 18 years of age. And over the last few years, he frequently no-showed visits, and when he did show up, he always inevitably forgot to bring his glucose logs or meter. His hemoglobin A1c has never been less than 12%. And literally every 6 weeks, he would present with florid DKA, only to be treated in the ICU and then spends a few days on the floor. The few times I saw him in the hospital, he had his Xbox hooked up and had a bunch of friends in his room playing games and eating chips. If I hadn't known better I'd have thought that he actually enjoys being in the hospital.

Despite the office no-shows and the high glucoses, he'd always deny missing his medications. And he'd always offer some excuse or another for missing an appointment in our office.

Things came to a head last month when he cancelled yet another appointment. "Couldn't get a ride to the office", apparently. And then an hour later, his mother calls, and angrily demands to speak to the clinic director.

She accuses us of not taking good care of her son. That it was unfair that Dr. Vagus "was so behind in his schedules that he turned my son away". And that's when she was informed that her son did not show up for the appointment; instead, 12 mins after the supposed appointment time had called offering that excuse. Except that his mother herself had dropped him off at our clinic. A lightbulb went on in her head: her son had called from the lobby to cancel the appointment, and went God-knows-where instead. And blatantly lied to his mother.

Indeed, suspecting something amiss, I had called his pharmacy to audit his insulin usage and he had been missing over 75% of his doses. I shared that information with his mother as well.

And so, when he next finally shows up, this time with family sternly accompanying him, I laid things out frankly. Perhaps he's used to being treated as a child, but I told him that as an adult, he can do pretty much whatever he wants to to himself. He could skip his insulins, smoke weed all day, kill himself or whatever's left of his body. But at the very least, to act like an adult and be honest about it; I told him he blatantly lied, and had accused us instead for his shortcomings. I firmly told him that he violated the trust I had in him. And I gave him an ultimatum; if he misses another visit with me, I shall have no choice but to dismiss him from my practice.

Saturday, September 08, 2012

RIP

In one of thosewhat-the-f*ck moments, we just found out a good friend from far away has suddenly died. Kris and I are still reeling from the shock of hearing the news, and we have countless questions as to why though we'll probably only find out much later. We only know it happened. Why, when, how?

It's been 5 years since we last saw him. We've had some good times way back when. And though it's been years since we last met in Singapore, we send them Christmas cards every year. And I called and chatted with him perhaps 5-6 months ago. And as it always does, Facebook fools you into feeling that you're somewhat staying in touch with faraway friends and family.

The world has lost another wonderful man, another dedicated doctor. Far too young. And it's made more painful realizing that this is the 2nd friend I've lost in the last 2 years from that golden era of residency. Looking at some of our photos, it's sombering to realize that of the few of us in that one photo, 2 are no longer with us.

I mourn for my friend. I mourn for his wife who has to face the world without him know. I mourn for his family.

Gene, we'll miss you. Till we meet again, may God keep you safe and loved in His hands. Perhaps, you and our buddy TS are now rejoicing and enjoying a drink at your reunion, somewhere up there in a beautiful place.

Wednesday, September 05, 2012

I saw Jim in the hospital the other day. An 82 year old man with follicular thyroid cancer, someone I had seen for years. At visits, his TSH levels seem to always fluctuate. And for a guy as lean as he was, he was taking 300 mcg of T4 just to suppress his TSH to where it ought to be for his stage of cancer. Which sometimes may be a hint that compliance or absorption is an issue. But at every visit, he would deny missing his doses. And his dear old wife of 60 years would always remind him: "Dear, remember you missed those few days?"

I remember her well. Short, in contrast to his 6-foot stature. Sweet smile, wrinkles but always blue eye-shadow. And whenever I called with results, she would be the one I'd talk to because his hearing aids made it difficult to understand an accented doctor on the phone.

And so, I was surprised when he was admitted for myxedema coma. My colleague who admitted him found his TSH to be over 100. When we did some investigating, it seems that he had not picked up any prescription refills since June, which explains a lot about his condition. But says nothing about why it happened.

And then the nurse tells me: His wife passed away this last May.

And perhaps out of devastation? Or simply because there was no one to remind him? Or maybe he just lost the will to live? I don't know.

He was still quite somnolent when I saw him in the ICU today. I held his hand, and spoke to him- I don't think he quite heard me.

But I hope he gets better. And wherever she is, I hope she helps him find the will to live on.

About Me

A Malaysian endocrinologist, trained in a major academic center in USA, and now starting out in the world of practice after 12 years of training.
To maintain patient confidentiality, names, ages and genders have been altered (And some stories totally fabricated to fool gullible readers).
This site is not meant to provide medical advice or consultation.